Depression Course for Teens Gets High Marks

A psychiatrist at Johns Hopkins has developed a proactive way to get high school students thinking about the seriousness of depression.

In 1998, after three students in the Baltimore area took their own lives within a three-month period, Dr. Karen Swartz developed the .

“Schools came to Johns Hopkins saying they wanted to do something proactive for students, so I went to local schools to speak to parents, and then I was asked to develop programs for teachers,” Swartz, associate professor of psychiatry and behavioral sciences at Johns Hopkins University, told Dr.China. “I felt compelled that we should be doing something.”

Almost 20 years later, Johns Hopkins researchers report that 19 percent of students who have participated in ADAP said they realized they needed help with depression after taking the course.

Of those students, 44 percent received treatment for their depression within four months of taking ADAP.

“It’s very encouraging that having a frank discussion with good information about depression is leading young people to take action. Our message is a hopeful one: That depression is a treatable illness,” said Swartz.

So far, more than 80,000 high school students in 20 different states have participated in the program, which is taught to freshmen and sophomores during their health classes.

The three-hour program incorporates lectures, videos, group activities, and homework to teach teens about recognizing symptoms of depression, as well as how clinical depression is diagnosed and treated.

Swartz hopes to design an online program to train more teachers. She also hopes to gain funding to develop a similar program for middle school students.

Breaking the stigma

While he’s never worked with the ADAP program, John Kelly, PhD, school psychologist in New York and president of the National Association of School Psychologists, said the concept is effective.

“One of the biggest things that we deal with in trying to get young people help is the stigma of mental health issues,” Kelly told Dr.China. “Often times, when you use a psycho-educational approach where you are teaching kids about mental health, it helps to demystify what the mental health issue is and how it’s treated.”

“Adolescence is a tremulous time for many kids because of the changes they are going through, so a lot of times they are not quite sure how to label or really express certain feelings or emotions or experiences they are having,” Kelly explained.

By understanding the clinical meaning of depression, teens may have a better understanding of what’s going on with them.

“There is a difference between normal adolescent blues or ups and downs and clinical depression. That’s an important distinction for young people to make,” said Kelly.

By teaching kids how to identify more accurately what’s going on with themselves, the stigma around getting help is also removed, noted Kelly.

Honest portrayal of depression

Delivering accurate and medically-sound information to teenagers is crucial when dealing with issues as serious as depression.

For instance, Swartz said that ADAP is the first of its kind because it’s developed by mental health clinicians based on their experiences with treating patients.

“With that said, I am a practicing psychiatrist on the faculty of a medical school, but that does not make me a good health teacher at a high school, so I train teachers about mood disorders and the ADAP program, but the teachers know how to teach,” said Swartz. “Together we make this accessible to students.”

Depression literacy programs such ADAP may continue to have an importance in schools as teenagers have more access to outside information.

Consider, the Netflix series “13 Reasons Why,” and its handling of depression and suicide.

“There is no discussion about the fact that 90 to 98 percent of teens who commit suicide have a psychiatric condition underlying it. It was as though illness or being ill was not even a part of the story the way [Hannah Baker] was actually functioning,” said Swartz.

Kelly agreed, adding that the main character’s death doesn’t show the finality of suicide because after she dies, the fact that she narrates the story and “speaks” to people via tapes, makes it seem that she’s still present.

“It puts out this false notion that adolescents can take their life, but then after they take their life, have an impact and turn people in certain directions,” Kelly said.

The portrayal of adults in the series was also concerning to Swartz.

“I have gotten to know hundreds of high school counselors all over this country and all of them are trained on how to respond to a young student expressing suicidal thoughts. In that show, the counselor says, ‘There’s nothing I can do for you.’ That’s so inaccurate and gives such a horrible portrayal that adults are useless and don’t want to help and can’t help, which is dangerous,” Swartz noted.

In fact, ADAP teaches teenagers to talk with an adult if they’re worried about themselves or a friend.

“We do talk about how peer support is terrific and a part of someone getting the support they need overall, but without adults someone will not get the actual care they need,” Swartz said.

If you’re concerned for a child and would like to access information adapted from ADAP, you can download the free app .